Factors which promote sustainability of a neonatal intensive care education program in an emerging country

Leslie Diane Mancuso, University of Pennsylvania


The purpose of this study was to determine factors that are critical in promoting the sustainability of an intensive neonatal health care educational program which was introduced into China by a private voluntary organization based in the United States. There has been little research on the sustainability of imported health care technology and education in an emerging country. Since the 1980's many programs, with external international assistance have been initiated, but once the financial and human resource support has been withdrawn the lasting effects have been questionable. Although grant requirements are being placed on international organizations, there are minimal empirical data to support what in the educational project design and implementation is integral for sustainability. The primary questions of the study include: (1) What factors must be considered when developing, implementing and evaluating a high technology health education program that will allow for sustainability in the merging of two cultures? (2) Will these factors promote the achievement of the goals of the project? A case study analysis was conducted of the primary site and three secondary sites using a thorough review of the PVOs neonatal education program materials and official documents, semistructured interviews, observations, and informal discussions. Six factors identified in the study were shown to have an impact on sustainability: training, political context, program financing, economic context, mutually negotiated process and institutional capacity. The orientation and interaction of the factors within each system were different but the sustainability remained intact in all units except one. The training factor was a prominent factor in all the sustainable programs and a significant finding was the transference of knowledge and skills from the primary site to secondary sites within the country. The process of mutual negotiation goals and strong leadership in the unit and hospital and the support from the country and community proved to be important to the long term sustainability. Although economics and program financing impacted on the program, it was not the determining factor for sustainability.

Subject Area

Health education|Public health|Social structure

Recommended Citation

Mancuso, Leslie Diane, "Factors which promote sustainability of a neonatal intensive care education program in an emerging country" (1997). Dissertations available from ProQuest. AAI9727258.